Intestinal Research

Original Articles

Colorectal neoplasia

Development and validation of a scoring system for advanced colorectal neoplasm in young Korean subjects less than age 50 years: Ji Yeon Kim, Sungkyoung Choi, Taesung Park, Seul Ki Kim, Yoon Suk Jung, Jung Ho Park, Hong Joo Kim, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Kyu Yong Choi, Dong Il Park; Intest Res 2019;17(2):253-264. Published online November 20, 2018; DOI: https://doi.org/10.5217/ir.2018.00062

Background/Aims
Colorectal cancer incidence among patients aged ≤50 years is increasing. This study aimed to develop and validate an advanced colorectal neoplasm (ACRN) screening model for young adults aged <50 years in Korea.
Methods
This retrospective cross-sectional study included 59,575 consecutive asymptomatic Koreans who underwent screening colonoscopy between 2003 and 2012 at a single comprehensive health care center. Young Adult Colorectal Screening (YCS) score was developed as an optimized risk stratification model for ACRN using multivariate analysis and was internally validated. The predictive power and diagnostic performance of YCS score was compared with those of Asia-Pacific Colorectal Screening (APCS) and Korean Colorectal Screening (KCS) scores.
Results
41,702 and 17,873 subjects were randomly allocated into the derivation and validation cohorts, respectively, by examination year. ACRN prevalence was 0.9% in both cohorts. YCS score comprised sex, age, alcohol, smoking, obesity, glucose metabolism abnormality, and family history of CRC, with score ranges of 0 to 10. In the validation cohort, ACRN prevalence was 0.6% in the low-risk tier (score, 0–4), 1.5% in the moderate-risk tier (score, 5–7), and 3.4% in the high-risk tier (score, 8–10). ACRN risk increased 2.5-fold (95%CI, 1.8–3.4) in the moderate-risk tier and 5.8-fold (95%CI, 3.4–9.8) in the high-risk tier compared with the low-risk tier. YCS score identified better balanced accuracy (53.9%) than APCS (51.5%) and KCS (50.7%) scores and had relatively good discriminative power (area under the curve=0.660).
Conclusions
YCS score based on clinical and laboratory risk factors was clinically effective and beneficial for predicting ACRN risk and targeting screening colonoscopy in adults aged <50 years.

Citations

Citations to this article as recorded by

Response to commentaries on “Performance of the Asia‐Pacific colorectal screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review”
MN Luu, DT Quach
Journal of Gastroenterology and Hepatology.2025; 40(1): 337. CrossRef
Family History of Colorectal Cancer and the Risk of Colorectal Neoplasia: A Systematic Review and Meta-Analysis
Kai Gao, Huyi Jin, Yi Yang, Jiayu Li, Yuanliang He, Ruiyao Zhou, Wanting Zhang, Xiangrong Gao, Zongming Yang, Mengling Tang, Jianbing Wang, Ding Ye, Kun Chen, Mingjuan Jin
American Journal of Gastroenterology.2025; 120(3): 531. CrossRef
Development and Internal Validation of a Machine Learning-Based Colorectal Cancer Risk Prediction Model
Deborah Jael Herrera, Daiane Maria Seibert, Karen Feyen, Marlon van Loo, Guido Van Hal, Wessel van de Veerdonk
Gastrointestinal Disorders.2025; 7(2): 26. CrossRef
Performance of the Asia–Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review
Mai Ngoc Luu, Nhi Ai Trinh, Truc Le Thanh Tran, Thinh Phuong Dang, Toru Hiyama, Duc Trong Quach
Journal of Gastroenterology and Hepatology.2024; 39(6): 1000. CrossRef
Updated epidemiology of gastrointestinal cancers in East Asia
Junjie Huang, Don Eliseo Lucero-Prisno, Lin Zhang, Wanghong Xu, Sunny H. Wong, Siew C. Ng, Martin C. S. Wong
Nature Reviews Gastroenterology & Hepatology.2023; 20(5): 271. CrossRef
From Algorithms to Clinical Utility: A Systematic Review of Individualized Risk Prediction Models for Colorectal Cancer
Deborah Jael Herrera, Wessel van de Veerdonk, Daiane Maria Seibert, Moges Muluneh Boke, Claudia Gutiérrez-Ortiz, Nigus Bililign Yimer, Karen Feyen, Allegra Ferrari, Guido Van Hal
Gastrointestinal Disorders.2023; 5(4): 549. CrossRef
Emergence of a New Optical Marker for Colorectal Neoplasms: To What Extent Should We Accept It?
Han Hee Lee
Clinical Endoscopy.2022; 55(2): 315. CrossRef
Is early-onset cancer an emerging global epidemic? Current evidence and future implications
Tomotaka Ugai, Naoko Sasamoto, Hwa-Young Lee, Mariko Ando, Mingyang Song, Rulla M. Tamimi, Ichiro Kawachi, Peter T. Campbell, Edward L. Giovannucci, Elisabete Weiderpass, Timothy R. Rebbeck, Shuji Ogino
Nature Reviews Clinical Oncology.2022; 19(10): 656. CrossRef
Strategies for colorectal cancer screening and post-polypectomy surveillance for young adults under age 50
Yoon Suk Jung
Precision and Future Medicine.2021; 5(2): 69. CrossRef
How to Choose the Optimal Bowel Preparation Regimen for Colonoscopy
Ji Eun Na, Eun Ran Kim
The Ewha Medical Journal.2021; 44(4): 122. CrossRef
The Role of Diet and Lifestyle in Early-Onset Colorectal Cancer: A Systematic Review
Marta Puzzono, Alessandro Mannucci, Simone Grannò, Raffaella Alessia Zuppardo, Andrea Galli, Silvio Danese, Giulia Martina Cavestro
Cancers.2021; 13(23): 5933. CrossRef
Association between waist circumference and risk of colorectal neoplasia in normal‐weight adults
Yoon Suk Jung, Nam Hee Kim, Hyo‐Joon Yang, Soo‐Kyung Park, Jung Ho Park, Dong Il Park, Chong Il Sohn
Journal of Gastroenterology and Hepatology.2020; 35(1): 43. CrossRef
Risk prediction rule for advanced neoplasia on screening colonoscopy for average-risk individuals
Ala I Sharara, Ali El Mokahal, Ali H Harb, Natalia Khalaf, Fayez S Sarkis, Mustapha M El-Halabi, Nabil M Mansour, Ahmad Malli, Robert Habib
World Journal of Gastroenterology.2020; 26(37): 5705. CrossRef
Risk Factors Associated With Young-Onset Colorectal Adenomas and Cancer: A Systematic Review and Meta-Analysis of Observational Research
Genevieve Breau, Ursula Ellis
Cancer Control.2020;[Epub] CrossRef
Prevalence and risk factors of colorectal cancer in Asia
Martin CS Wong, Hanyue Ding, Jingxuan Wang, Paul SF Chan, Junjie Huang
Intestinal Research.2019; 17(3): 317. CrossRef

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Is methylation analysis of SFRP2, TFPI2, NDRG4, and BMP3 promoters suitable for colorectal cancer screening in the Korean population?: Soo-Kyung Park, Hae Lim Baek, Junghee Yu, Ji Yeon Kim, Hyo-Joon Yang, Yoon Suk Jung, Kyu Yong Choi, Hungdai Kim, Hyung Ook Kim, Kyung Uk Jeong, Ho-Kyung Chun, Kyungeun Kim, Dong Il Park; Intest Res 2017;15(4):495-501. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.495

Abstract PDF PubReader ePub

<b>Background/Aims</b><br/>

Colorectal cancer (CRC) screening using stool DNA was recently found to yield good detection rates. A multi-target stool DNA test (Cologuard®, Exact Sciences), including methylated genes has been recently approved by the U.S. Food and Drug Administration. The aim of this study was to validate these aberrantly methylated genes as stool-based DNA markers for detecting CRC and colorectal advanced adenoma (AA) in the Korean population.

Methods

A single-center study was conducted in 36 patients with AA; 35 patients with CRC; and 40 endoscopically diagnosed healthy controls using CRC screening colonoscopy. The methylation status of the SFRP2, TFPI2, NDRG4, and BMP3 promoters was investigated blindly using bisulfate-modified stool DNA obtained from 111 participants. Methylation status was investigated by methylation-specific polymerase chain reaction.

Results

Methylated SFRP2, TFPI2, NDRG4, and BMP3 promoters were detected in 60.0%, 31.4%, 68.8%, and 40.0% of CRC samples and in 27.8%, 27.8%, 27.8%, and 33.3% of AA samples, respectively. The sensitivities obtained using 4 markers to detect CRC and AA were 94.3% and 72.2%, respectively. The specificity was 55.0%.

Conclusions

Our results demonstrate that the SFRP2, TFPI2, NDRG4, and BMP3 promoter methylation analysis of stool sample DNA showed high sensitivity but low specificity for detecting CRC and AA. Because of the low specificity, 4 methylated markers might not be sufficient for CRC screening in the Korean population. Further large-scale studies are required to validate the methylation of these markers in the Asian population and to find new markers for the Asian population.

Citations

Citations to this article as recorded by

Evolution of non-invasive colorectal neoplasm detection
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World Journal of Gastrointestinal Oncology.2026;[Epub] CrossRef
Methylation biomarkers for early detection of colorectal cancer: From molecular discovery to clinical translation and application
Yangfeng Huang, Wei Jiang, Jianhong Kang
Journal of Cancer Research and Therapeutics.2026; 22(2): 231. CrossRef
Translational feasibility of a plasmonic microarray–based liquid biopsy for KRAS codon mutation detection across tissue, plasma, and urine in early colorectal cancer
Ji Young Lee, Chae Won Mun, Eun Ran Kim, Sung-Gyu Park, Min-Young Lee
npj Precision Oncology.2026;[Epub] CrossRef
Effectiveness of single-target fecal DNA methylation test in regional mass screening for colorectal cancer and precancerous lesions in China
Xianhe Kong, Qiuning Wu, Zhi Zhang, Zhiqiang Yu, Feng Niu, Xianshu Wang, Hongzhi Zou
Gastroenterology Report.2025;[Epub] CrossRef
Diagnostic value of genetic and epigenetic biomarker panels for colorectal cancer detection: a systematic review
Georgios Alampritis, Sarah Nohelia Thoukididou, Maria Ramos, Pantelis Georgiou, Melpomeni Kalofonou, Constantinos Simillis
International Journal of Colorectal Disease.2025;[Epub] CrossRef
Advances in colorectal cancer screening: technological innovations, guideline discrepancies, and individualized strategies
Li Tang, Xiaoyong Zhao, Guohong Wang, Jiehao Huang, Mu Zhang, Wei Xu
Frontiers in Oncology.2025;[Epub] CrossRef
DNA methylation modulates epigenetic regulation in colorectal cancer diagnosis, prognosis and precision medicine
Jingxin Ye, Jianfeng Zhang, Weifeng Ding
Exploration of Targeted Anti-tumor Therapy.2024; 5(1): 34. CrossRef
Pathogenesis and biomarkers of colorectal cancer by epigenetic alteration
Chang Kyo Oh, Young-Seok Cho
Intestinal Research.2024; 22(2): 131. CrossRef
Tissue factor pathway inhibitor-2 (TFPI-2)—an underappreciated partaker in cancer and metastasis
Marek Z. Wojtukiewicz, Marta Mysliwiec, Anna Tokajuk, Joanna Kruszewska, Barbara Politynska, Anmbreen Jamroze, Anna M. Wojtukiewicz, Dean G. Tang, Kenneth V. Honn
Cancer and Metastasis Reviews.2024; 43(4): 1185. CrossRef
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Daša Jevšinek Skok, Nina Hauptman
International Journal of Molecular Sciences.2023; 24(16): 12692. CrossRef
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Huafeng Jiang, Senjun Zhou, Gang Li
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Gastroenterología y Hepatología.2022; 45(10): 753. CrossRef
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Maartje Massen, Kim Lommen, Kim A. D. Wouters, Johan Vandersmissen, Wim van Criekinge, James G. Herman, Veerle Melotte, Leo J. Schouten, Manon van Engeland, Kim M. Smits
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Jiayi Mu, Yanqin Huang, Shanrong Cai, Qilong Li, Yongmao Song, Ying Yuan, Suzhan Zhang, Shu Zheng
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Inter-Physician Variation in Treatment for Patients with Crohn's Disease: Hwang Choi, Sang Woo Kim, Kang Moon Lee, Bo In Lee, Dae Young Cheung, Min Kuk Kim, Hyun Jung Jung, Hyung Keun Kim, Jeong Seon Ji, Soo Heon Park, Hiun Suk Chae, Myung Gyu Choi, Kyu Yong Choi, In Sik Chung; Intest Res 2009;7(1):41-46. Published online June 30, 2009

Abstract PDF: Background/Aims
The incidence and prevalence of Crohn's disease are increasing in Korea. However, the guidelines for the management of Crohn's disease have not been established in Korea. In the current study we determined the difference in the treatment methods between physicians in Korea for Crohn's disease. Methods: We retrospectively analyzed the use of medical and surgical treatment modalities in 92 patients with newly diagnosed Crohn's disease. We compared the treatment strategies among 4 physicians at 3 different institutions. Results: Prednisone, 5-aminosalicylates, antibiotics, immunomodulators, infliximab, and surgery were prescribed or preformed in 64%, 92%, 24%, 35%, 9%, and 22% of the patients, respectively. The surgical procedures included 12 bowel resections and 8 fistulectomies. The prescription rates for 5-aminosalicylates, prednisone, antibiotics, and infliximab did not differ, but of the use of immunomodulators was significantly different between physicians (p=0.012). The mean interval between diagnosis and the start of immunomodulators was 14 months, and was not different between physicians. The median dosage of immunomodulators was 50 mg per day, and was not different between physicians. Conclusions: A difference in medical treatment strategies for Crohn's disease between physicians exists in Korea. Specifically, there was a significant difference in the use of immunodulators between physicians. The development of treatment guidelines for Crohn's disease, together with efforts to decrease the inter-physician difference for treating Crohn's disease are needed. (Intest Res 2009;7:41-46)

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Endoscopic Differentiation of Small Bowel Strictures: Hwang Choi, Kyu Yong Choi, Bo In Lee, Min Kuk Kim, Hyun Jung Jung, Jeong Seon Ji, Tae Ho Kim, Jung Hwan Oh, Kang Moon Lee, Sang Woo Kim, Soo Heon Park, Hiun Suk Chae, Myung Gyu Choi, Sok Won Han, In Sik Chung; Intest Res 2007;5(1):38-44. Published online June 30, 2007

Abstract PDF: Background/Aims
The diagnosis of small bowel stricture was made by operation. Capsule endoscopy has been useful for diagnosis of small bowel diseases but has limited value in cases with stricture. Double balloon endoscopy is the useful method to visualize the entire small bowel. The aims of this study are to evaluate the feasibility of double balloon endoscopy and to differentiate the endoscopic findings in patients with small bowel stricture. Methods: Between March 2004 and February 2007, fifteen consecutive patients were referred for the evaluation of small bowel stricture. Small bowel strictures were suspected in small bowel series and CT in eleven patients. Capsule endoscopies were performed in six patients and entrapped in three patients. Double balloon endoscopy (EN-450P5/20, Fujinon, Japan) was performed with midazolam (median 5 mg, range 5-10 mg) and meperidine (median 50 mg, range 50-100 mg). All lesions except one were found within 60 minutes. One patient had been excluded because of false-positive finding of capsule endoscopy. Clinical and endoscopic findings were compared between strictures of Crohn's disease (group I, n=6) and those of other causes (group II, n=8). Results: Double balloon endoscpies were performed with good tolerance without side effect. Age, chief complaints, duration of symptom, and initial hemoglobin and serum albumin levels were not different between two groups. The proportion of male sex was higher in group I than group II (100%, 38%, respectively; p=0.031). The strictures below 0.5 cm in diameter were 83% in group I and 13% in group II (p=0.026). The arrangement of stricture in group I was more eccentric than that in group II (100%, 17%, respectively; p=0.015). The location of stricture, appearance of surrounding mucosa, associated ulcer, and ulcer margin were not different between two groups. Conclusions: Endoscopic differentiation using double balloon endoscopy can be made easily and safely in patients with small bowel stricture. The strictures of small bowel in patients with Crohn's disease were narrower and more eccentric than those in patients with other diseases. (Intest Res 2007;5:38-44)

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The Inflamed Appendiceal Orifice does not Always Suggest Acute Appendicitis: Min Huh, Bo-In Lee, Kyu Yong Choi, Kyoung Mee Kim, Jeong Seon Ji, Byung Wook Kim, Hwang Choi, Se Hyun Cho, Woo Chul Chung, Kang Moon Lee, Sok Won Han, In Sik Chung; Intest Res 2006;4(1):39-44. Published online June 30, 2006

Abstract PDF: Background/Aims
Colonoscopy may be helpful in the diagnosis of appendicitis occasionally. However, it is unclear that isolated inflammation at the appendiceal orifice is always suggestive of acute appendicitis. Methods: Eighteen consecutive patients with colonoscopic findings of the isolated inflammatory lesion in the area of the appendiceal orifice were included. Surgical- pathology-proven appendicitis within 6 months after the colonoscopy were defined as 'true-appendicitis'. Results: Of the 18 patients, 16 patients were followed up for more than 6 months. Seven patients underwent appendectomy within 5-79 days after the colonoscopy. Of these, 4 patients (25%) had true-appendicitis, one periappendiceal abscess without appendicitis, two normal appendices. Nine patients did not take appendectomy. Of these, no definite etiology was defined in 6. Of the rest, one patient revealed Crohn's disease, one Behcet's disease and one cecal involvement of distal ulcerative colitis later. Conclusions: Isolated inflammation at the appendiceal orifice does not always suggest acute appendicitis but diverse etiologies. The diagnosis of appendicitis should not be made only by colonoscopic findings but also by clinical course and other imaging studies. (Intestinal Research 2006;4:39-44)

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Clinical Usefulness of Centrifugal Leukapheresis in the Patients with Steroid-dependent Ulcerative Colitis: Long-term Follow-up Result: Hwang Choi, Kyu Yong Choi, Bo In Lee, Hyong Ju Kang, Soo Jeong Park, Byung Wook Kim, Chi Wha Han, In Sik Chung; Intest Res 2005;3(2):110-116. Published online December 30, 2005

Abstract PDF: Background/Aims
Although the etiologies of ulcerative colitis have not been proven yet, activated leukocytes have a great role in the pathogenesis of ulcerative colitis. We studied to evaluate the long-term clinical usefulness and adverse effect of the leukocyte removal technique (leukapheresis) for the patients with steroid-dependent ulcerative colitis. Methods: Eight patients who had performed leukapheresis for management of steroid-dependent active ulcerative colitis were analyzed retrospectively. We used a centrifugal method (Cobe Spectra, Gambro BCT, Inc, USA) for the leukapheresis. The schedule was one session weekly for 5 weeks of intensive therapy and one session monthly of maintenance therapy. The number of leukapheresis performed was average of 9.5 cycles. The simple clinical colitis activity index (SCCI) and complete blood counts were checked before and after each sessions of leukapheresis. We observed the side effects of leukapheresis and clinical outcomes of the patients over 2 years. Results: After 5 sessions of leukapheresis, the average SCCI decreased from 8.75 to 0.5 (p＜0.001). All patients could easily taper the steroid dose during leukapheresis and 7 patients stopped the use of steroid after leukapheresis. During mean follow-up of 44 months, 4 patients relapsed and started steroid and 6-mercaptopurine. Two patients complained of numbness and parasthesia on the face and fingers during leukapheresis and theses symptoms were relieved after the injection of calcium. Conclusions: Centrifugal leukapheresis was an effective and safe method for the treatment of the patients with steroid-dependent active ulcerative colitis. We expect further prospective controlled studies. (Intestinal Research 2005;3:110-116)

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Clinicopathological Characteristics and Malignant Potential of Colonic Flat Adenomas Compared to That of Polypoid Adenomas: Myeong Gwan Jee, Hyun Soo Kim, Won Ho Kim, Tae Il Kim, Dong Il Park, Young-Ho Kim, Hyo Jong Kim, Jeong-Sik Byeon, Suk-Kyun Yang, Moon Sung Lee, Il Kwon Jung, Sung-Ae Jung, Yoon Tae Jeen, Jai Hyun Choi, Hwang Choi, Kyu Yong Choi, Dong Soo Han; Intest Res 2005;3(2):127-132. Published online December 30, 2005

Abstract PDF: Background/Aims
Colorectal flat adenomas have been a topic of debate in the view of malignant potential. The aims of this study are to investigate the clinicopathological features of flat adenomas compared to that of polypoid adenomas and to identify the determinants for malignant transformation in colorectal flat and polypoid adenomas. Methods: This was a prospective, cross sectional study of 3,360 patients who diagnosed as adenomas via total colonoscopy and polypectomy at 13 tertiary medical centers between July 2003 and July 2004. Potential risk factors for malignant transformation were analyzed. Results: Out of 3,360 adenomas, 207 (6.2%) were flat adenomas and 3,153 (93.8%) were polypoid adenomas. The patients with flat adenoma were older (59.6 vs. 57.1, p＜0.01) and more frequently located in the right colon than polypoid adenomas (49.3% vs. 32.0%, p<0.01). The incidence of high grade dysplasia or cancer in flat adenomas was similar to that of polypoid adenomas (5.4% vs. 4.6%, p=0.36). Multivariate analysis revealed that the size ≥11 mm (OR 6.8; 95% CI 4.8-9.7) and location of adenoma in the left colon (OR 1.6; 95% CI 1.07-2.38) were significant determinants for malignant potential of colonic adenoma. Conclusions: Clinicopathological determinants for malignant potential in colorectal adenomas were not gross morphology but size and location of adenoma. (Intestinal Research 2005;3:127-132)

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Case Report

Cancer Cell Seeding by Tattooing for Tumor Localization before Laparoscopic Lower Anterior Resection: Hyong Ju Kang, Bo In Lee, Byung Wook Kim, Hwang Choi, Se Hyun Cho, Kyu Yong Choi, Hiun Suk Chae, Seok Won Han, In Sik Chung, Kyoung Mee Kim; Intest Res 2005;3(2):150-153. Published online December 30, 2005

Abstract PDF: Endoscopic mucosal resection is accepted standard treatment of early gastrointestinal cancer, defined as cancer with involvement confined to the mucosa without lymph node metastasis. Under the therapeutic endoscopy, submucosal saline injection minimize the risks of transmural burn, perforation, bleeding. As laparoscopic colectomy became popular recently, colonoscopic tattooing of lesions to assist for localization in surgical field is in the spotlight. Four submucosal saline injections around the lesion, performed with an injection needle to test for the possibility of EMR, showed an obvious 'non-lifting sign'. Therefore we performed endoscopic tattooing, and then experienced tumor cell seeding on tattooing site. Manipulation of cancerous tissue with submucosal saline injection or tattooing can have a risk of tumor cell seeding on injection sites at any time. Furthermore, if bowel wall is perforated, peritoneal metastasis or seeding are possible. In this case, we approached and injected saline carefully for prevention of cancer penetration. (Intestinal Research 2005;3:150-153)

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Original Article

Usefulness of Double-Balloon Enteroscopy in Patients with Gastrointestinal Bleeding: Jeong Seon Ji, Hwang Choi, Kyu Yong Choi, Bo In Lee, Byung Wook Kim, Se Hyun Cho, Hyun Suk Chae, In Sik Chung; Intest Res 2004;2(2):102-106. Published online December 22, 2004

Abstract PDF: Background/Aims
Patients with obscure gastrointestinal bleeding are a diagnostic and therapeutic challenge. Double-balloon enteroscopy is the useful method to visualize the entire small bowel. The aim of this study is to evaluate the usefulness of the double-balloon enteroscopy in patients with gastrointestinal bleeding. Methods: Between March 2004 and August 2004, eight patients were referred for obscure gastrointestinal bleeding. Routine gastrointestinal and colonoscopy were not diagnostic in all patients. Results: The double-balloon endoscopy system was used to perform 12 enteroscopies (6 by the antegrade approach and 6 by the retrograde approach). In four patients, whole small bowel was examined. Duration of bleeding ranged from several days to 10 years. The source of bleeding was identified in 6 (75%) of 8 patients. Interestingly, source of bleeding was more found patients with long bleeding duration and with history of multiple transfusion due to low hemoglobin level less than 10 g/dL. In three patients, lesion was within the range of gastrointestinal and colonoscopy. Conclusions: Double-balloon enteroscopy is a useful method in patients with obscure gastrointestinal bleeding. This is preliminary report and further studies are required to reach a conclusion. (Intestinal Research 2004;2:102-106)

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Case Reports

A Case of Large Polypoid Arteriovenous Malformation of Colon Treated with Detachable Snare: Jeong Seon Ji, Bo In Lee, Byung Wook Kim, Hwang M.D., Se Hyun Cho, Kyu Yong Choi, Woo Chul Chung, Kang Moon Lee, Hyun Suk Chae, In Sik Chung, Kyong Mee Kim; Intest Res 2004;2(1):36-39. Published online April 16, 2004

Abstract PDF: Arteriovenous malformation is well known cause of lower gastrointestinal bleeding in elderly patients. This is relatively uncommon in people younger than 50 years of age. Endoscopically, it generally appears as bright red flat or elevated bright red lesion. A polypoid appearance is extremely uncommon. We report a case of large polypoid arteriovenous malformation of colon in 81-year-old male patient. He has complained of hematochezia for 4 days. During colonoscopy, a 3.5 cm sized semipedunculated polypoid mass in the proximal transverse colon was detected. For prevention of bleeding, detachable snare was applied and biopsy was done. 3 days later, follow up colonoscopy was done. There was no hemorrhege. We performed endoscopic mucosal resection. Polypoid arteriovenous malformation of colon was comfirmed by microscopic findings. Histologically, section of excised polyp shows ulceration, hemorrhage and the dilated, irregularly thick walled blood vessels in the mucosa and submucosa. (Intestinal Research 2004;2:36-39)

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A Case of Bacterial Overgrowth Syndrome Presenting Recurrent Edema and Hypoproteinemia After Billoth II Operation: Bo In Lee, Kyu Yong Choi, Byung Wook Kim, Hwang Choi, Se Hyun Cho, Woo Chul Chung, Kang Moon Lee, Soo Heon Park, Hyun Suk Chae, Myung Gyu Choi, In Sik Jung; Intest Res 2003;1(2):197-200. Published online November 27, 2003

Abstract PDF: Recently, we experienced a case of bacterial overgrowth syndrome with recurrent edema, hypoproteinemia and normal serum cobalamine level after Billoth II subtotal gastrectomy, which was diagnosed by jejunal aspirates culture and antibiotics treatment. When predisposition and clinical suspicion were present, jejunal culture might be preferable especially in case of post-Billoth II operation status because jejunal approach is easy, screening tests are negative in certain cases and some screening tests are not available in Korea. (Intestinal Research 2003;2:197-200)

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Rapid Growth of Early Colorectal Cancer in a Short Period: a Case Report: Bo In Lee, Kyu Yong Choi, Byung Wook Kim, Hwang Choi, Se Hyun Cho Cho, Woo Chul Chung Chung, Kang Moon Lee, Soo Heon Park, Hyun Suk Chae, Myung Gyu Choi, In Sik Jung; Intest Res 2003;1(1):64-67. Published online May 27, 2003

Abstract PDF: Retrospective studies report that doubling time of early colorectal cancer is 26 months. Recently we experienced a case of early colorectal cancer which increased over twofold in a size in only 13 days. (Intestinal Research 2003;1:64-67)

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